May 16, 2022 08:33AM lgp1111 wrote:

Hello all,

I have (for now) a single bone lesion in my left sacrum, which causes mild, occasional discomfort. I've been on Letrozole/Ibrance for several months and had two scans indicating the lesion is stable. My oncologist referred me to a radiation oncologist, who said SBRT was an option. However, in her professional opinion, there is a lack of overwhelming evidence in favor of SBRT. The message I got was: It might slow it down, it might not. Also, there are risks of fracture, nerve damage, etc. My question is: If you were offered SBRT, did you go forward with it? And are you glad you did? Did you have any complications?

Thanks so much for sharing your personal experience.

May 16, 2022 11:20AM cowgal wrote:

lgp1111 - I was not a candidate for SBRT because my bone lesion was too large (over 7 cm). However, I did get a targeted radiation to my lone bone met and it was more intense then the chest wall radiation I had received for my lower stage cancer in 2010. The RO did a more targeted/intense radiation plan then she would have normally given because of the possibility of me being an oligmetastatic and seeing this as an opportunity to get the cancer before it went somewhere else. Mine was in my collarbone. The RO should be able to tell you what possible risks you could get from radiation in that area. I lost a bit of arm mobility in my shoulder. I might have been able to get some of that back with PT done earlier but it happened right at the start of the COVID pandemic. I am glad I did it as the next scan done a couple of months after I completed radiation showed that I was NEAD! I have been NEAD since July 2020 (getting ready to go over recent scans this week with my MO and praying to GOD that I continue at that status. I am on Ibrance/Faslodex/XGEVA.

May 16, 2022 04:50PM lgp1111 wrote:

Thank you so much @olma61 @cowgal @sondraf

That is very helpful. I really appreciate it. Sondra, you are so right -- it could fracture without radiation. I needed that reminder. Thanks again everyone.

May 17, 2022 12:11AM - edited May 17, 2022 12:17AM by sondraf

I think especially to the sacrum - its so weight bearing down there and more difficult to "shore up" like a femur or a hip or even a vertebrae where they can throw in some hardware, replace completely, or stuff in some cement. And what you don't want to happen is to end up in a situation where you are in a lot of pain and then cannot walk or move comfortably to exercise. Get ahead of it before it gets ahead of you!

May 17, 2022 08:38AM sadiesservant wrote:

I think I’ve commented on my radiation treatments recently but will circle back given the conversation. I’ve had five separate treatments for bone met related pain since being diagnosed as metastatic in late 2016. It’s hard to remember the order of treatments now but I believe the first treatment was due to sudden onset of severe sciatica after progression on Arimidex. It was ridiculous in that I could barely stand in the morning, going to the bathroom was an adventure. One zap of the lumbar spine took care of the issue. Then, despite everything appearing to be stable, I later needed a zap to my right hip (I was having trouble walking) and then my sacrum. I have extensive bone mets which seem to progress slightly in spots.

I next had an issue with numbness and tingling in my right arm/hand. MRI didn’t show progression but I was having some facial numbness and, for the first time, they flagged skull mets and mets to my cervical spine. Apparently this is unusual (although I have certainly heard from many here who have skull mets) so they don’t typically scan for them - bone scans are useless for me so they didn’t show up. We took a wait and see approach given potential complications but about a year later I started getting severe headaches. Five sessions of rads to the base of my skull and upper c-spine resolved the issue. Now, last week, I finished five sessions to my c-spine/thoracic spine as a new lesion was impinging the nerves causing significant right shoulder pain and numbness of my right arm. I’m still recovering with no signs of improvement yet but I think there is quite a bit of inflammation from the treatment, despite the steroids. It can take several weeks to see results so I am trying to be patient, hoping there isn’t any permanent nerve damage.

I’ve never had SBRT. My understanding from my RO is that it would not have been appropriate in my case as it is very high intensity with the potential to cause significant collateral damage in delicate areas like the spine. Instead my RO chose a more targeted beam delivered over multiple sessions.

Wish me luck on recovery. I’m desperate to get off of the steroids - so sleep deprived! (And tired of the nasty taste. Yuck!) I tried to taper back but had to increase the dose again as the numbness was getting worse and there was a bit of breakthrough pain. I may try to dial it back again on Thursday. Here’s hoping.